'Stealth' gonorrhoea on the rise/more

[Guest guest]

http://www.newscientist.com/article/dn11355-stealth-gonorrhoea-on-the-rise.html

'Stealth' gonorrhoea on the rise

 

16:34 09 March 2007 NewScientist.com news service Lisa Hitchen

 

 

Related Articles

 

 

 

Cervical cancer virus is common in the US 27 February 2007 Syphilis rates skyrocket in China 12 January 2007 Lethal toxin is a turn-on for squids 20 November 2004

 

"Stealth" strains of gonorrhoea that fail to show up in tests are on the rise across the world, researchers have discovered, because the tests used by doctors to identify the bacteria look for an enzyme no longer present in those strains.

The rising prevalence of these strains was found in Australia, New Zealand, England, Scotland and Denmark. The findings should prompt clinics to change practice and use at least two tests that work in different ways to detect the infection, the scientists say.

The prolyliminopeptidase (PIP) enzyme was previously thought to be present in all strains of gonorrhoea and was therefore used in many diagnostic tests. However, mutations or deletions in the PIP gene that prevent the production of this enzyme had been identified in some strains. Gonorrhoea is known for its ability to mutate throughout its entire growth phase.

Magnus Unemo, a microbiologist at Orebro University Hospital, Sweden and colleagues examined a total of 41 samples lacking the PIP enzyme from patients in Australia, New Zealand and Scotland. The samples were obtained between 2001 and 2004.

To see how widespread this stealth strain is across the globe, they then compared these with samples from other studies in England and Denmark.

Widespread dissemination

All the samples from New Zealand and Scotland, and 83% of Australian samples, were indistinguishable or very similar to the English and Danish samples and had evolved from a single original strain. The data show "widespread dissemination" of the strain, the researchers say.

The strain was previously known to be circulating among homosexual men, but the new work suggests it has become a growing concern within the heterosexual population as well.

The strain did not appear resistant to the antibiotics typically used to treat gonorrhoea and all patients were given treatment.

Untreated gonorrhoea infections can cause severe and permanent health problems and can even be fatal. It can also cause infertility by harming the testicles or fallopian tubes. These risks mean it is "crucial that a rapid, highly sensitive and specific confirmation of N. gonorrhoeae is provided," the authors say.

Journal reference: Sexually Transmitted Infections (vol 83, p 47)

 

http://www.msnbc.msn.com/id/17364887/

1 in 4 women have STD linked to cervical cancer

But only tiny percentage infected with strains targeted by new vaccine

 

 

One in four U.S. women ages 14 to 59 is infected with the sexually transmitted virus that in some forms can cause cervical cancer, according to the first broad national estimate.

The figure is mostly in line with previous assessments. The highest prevalence — nearly 45 percent — was found in young women within the age range recommended for a new virus-fighting vaccine, according to a report from the federal Centers for Disease Control and Prevention.

Researchers have estimated that 20 million Americans have some form of HPV. The study concluded that 26.8 percent of U.S. women are infected, a figure that is comparable to earlier estimates using smaller groups.

We expected the prevalence of any HPV infection would be high and that’s what we found,” said CDC researcher Dr. Dunne, the study’s lead author.

Young women face highest risk

 

 

 

 

 

 

 

 

 

 

Test yourself

 

 

 

 

 

 

• Cervical cancer: What's your risk?

Just 3.4 percent of the women studied had infections with one of the four HPV strains that the new vaccine protects against. But that doesn’t mean the vaccine should be written off, said Dr. Yvonne Collins, an assistant professor of gynecologic cancer at the University of Illinois at Chicago.

For one thing, Collins said, that relatively small percentage corresponds with a lot of women — about 3 million, according to the report. And it does not include those with past infections that have cleared up.

The number of women with HPV strains targeted by the vaccine was lower than in some previous, less comprehensive estimates. And the overall HPV prevalence among the youngest women studied, 14-to-24-year-olds, was substantially higher than in previous estimates, 7.5 million versus 4.6 million.

Dunne attributed those variations to different study populations and different HPV detection methods. She said the results should not be interpreted to mean infection prevalence has changed in recent years.

The new nationally representative report is based on vaginal swab specimens from 1,921 women tested in 2003-04.

The report appears in Wednesday’s Journal of the American Medical Association.

Push behind vaccineThere are dozens of strains of HPV. Low-risk forms can cause genital warts and non-cancerous changes in cells in the cervix, and often clear without treatment. Several high-risk forms have been linked with cervical cancer.

Dunne said HPV prevalence is thought to be high in men as well, but none were studied.

An estimated 11,150 U.S. women will be diagnosed this year with cervical cancer, and about 3,670 will die from it. Numbers are much higher worldwide, especially in developing countries where Pap tests to detect cervical cancer are not routine.

The new vaccine, Merck’s Gardasil, was approved last June for girls and women aged 9 to 26. It protects against two HPV strains believed responsible for about 70 percent of cervical cancer cases, and two other strains that cause 90 percent of genital wart cases.

Other vaccines are in the works to protect against other HPV strains, Collins said.

 

 

 

 

 

 

Click for related content

 

 

 

 

 

 

Call for global use of cervical cancer vaccines When it comes to sex, do women settle for less? New breast cancer theory backed by folklore

 

Women aged 20 to 24 had the highest overall HPV prevalence in the study, 44.8 percent. Prevalence increased each year from ages 14 to 24, then dropped off gradually, confirming that young, sexually active women face the greatest risk of infection.

The study underscores the need for young women to get vaccinated, and to get routine Pap tests, said Dr. Howard Jones, a gynecologic cancer specialist at Vanderbilt University.

Dr. Richard Haupt, medical affairs director in Merck’s vaccine division, said the study “reinforces the idea that Gardasil would have great benefit” for young women.

 

 

 

 

 

 

 

 

 

 

 

 

 

Q & A

Human papillomavirus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

•

Introduction

 

 

 

•

How is HPV transmitted?

 

 

 

•

How many people have HPV?

 

 

 

•

Can you treat HPV?

 

 

 

•

What are the signs and symptoms?

 

 

 

•

How is HPV diagnosed?

 

 

 

•

How can you prevent HPV?

 

 

 

 

 

 

 

Human papillomavirus, or HPV, is a common cause of sexually transmitted disease. In some cases, the virus can form warts on various parts of the body, including the feet, hands and genitals. There are more than 100 types of HPV, most of which are harmless. Of these 100, more than 30 types are sexually transmitted. Some types of HPV that cause genital infections can also cause cervical cancer and other gynecological cancers.

 

 

 

Sources: Associated Press, National Institutes of Health, CDC

Recurrent chlamydia common in young women

More than half in study had STD, 30 percent had repeated outbreaks

http://www.msnbc.msn.com/id/17474192/

 

 

 

Nearly 30 percent of women in their late teens suffer recurrent infection with chlamydia, a rate higher than previously recognized in this population, new research shows.

Recurrent bouts of chlamydia "comprise a substantial health burden among young women," Dr. Linda M. Niccolai, from Yale University in New Haven, Connecticut, and colleagues note. Their findings, they say, suggest that enhanced efforts to prevent recurrent chlamydia infections in young women are "urgently needed."

The findings, which appear in the Archives of Pediatrics and Adolescent Medicine for March, stem from a study of 411 young women between the ages of 14 and 19 years old who visited one of 10 community-based health centers that provided reproductive health care between June 1998 and September 2001

 

 

The women were evaluated at the first visit and 6, 12 and 18 months later. A subset of 386 women was followed long term.

During an average follow-up of 4.7 years, 52.6 percent of subjects were diagnosed with chlamydia trachomatis infection. A total of 123 women or 29.9 percent of the total sample had recurrent infections.

Roughly half of all chlamydia infections diagnosed were recurrent and the median time to recurrent infection was 5.2 months, the authors note.

 

 

 

 

 

 

Click for related content

 

 

 

 

 

 

1 in 4 women have STD linked to cervical cancer To cut or not? Circumcision controversy flares

 

Prevention counseling, behavioral interventions, promotion of regular condom use and innovative partner-treatment strategies are some of the ways of potentially reducing recurrent chlamydia infections among young women, the authors say.

Chlamydia is one of the most common sexually transmitted disease among women and often causes no symptoms. The bacterial infection can lead to a whole host of problems including pelvic inflammatory disease, ectopic pregnancy and infertility. It can also make a woman more likely to acquire or pass on HIV.